UTILITY OF PET-MRI IN INITIAL STAGING, TREATMENT PLANNING AND FOLLOW UP OF GYNECOLOGIC CANCERS
RAJ MOHAN PASPULATI1, KARIN HERMAN1, and AMIT GUPTA1

1RADIOLOGY, UNIVERSITY HOSPITALS, CASE WESTERN RESERVE UNIVERSITY, CLEVELAND, OH, United States

Synopsis

In this exhibit we share our 3 year experience of sequential design PET-MR (Phillips Ingenuity TF PET/MR) application in staging and follow up of gynecologic cancers. Hybrid PET-MR imaging is a new evolving technique and has a useful role in staging, treatment planning and follow up of gynecologic cancers. Standardization of the imaging protocol and understanding its limitations and pit falls is essential before considering regular clinical application.

Purpose: 1.Application of PET-MR in initial staging, treatment planning and follow up of gynecologic cancers 2.Advantages and limitations of PET-MR

3.Work flow, technical challenges and pitfalls of PET-MR

Outline of content: FDG-PET CT and MRI are established imaging techniques for initial staging and follow up of gynecological malignancies. MRI is used for initial T- staging of cervical, vaginal and vulvar cancers and PET-CT for nodal and distant metastases (NM staging). Integrated Hybrid PET-MR systems are in clinical use for over 3 years for both oncologic and non-oncologic applications. In this exhibit we share our 3 year experience of sequential design PET-MR (Phillips Ingenuity TF PET/MR) application in staging and follow up of gynecologic cancers. This included initial staging and follow up after external beam & Brachytherapy of advanced cervical carcinoma ; staging and follow up of vulvar and vaginal after surgery of Radiation treatment; Initial staging and follow up after chemotherapy of advanced ovarian carcinoma; local recurrence of surgically treated endometrial cancer and its treatment planning. Patient compliance is an important factor in this hybrid imaging and MR scan timing has to be restricted to selected useful sequences. The exhibit illustrates the PET-MR work flow and optimal MRI sequences suitable for this complementary imaging technique. Strengths and weaknesses of MRI and FDG-PET in TNM staging will be discussed. Limitations of both imaging modalities in detection of lymph nodal and lung metastases will be illustrated.

Summary: Hybrid PET-MR imaging is a new evolving technique and has a useful role in staging, treatment planning and follow up of gynecologic cancers. Standardization of the imaging protocol and understanding its limitations and pit falls is essential before considering regular clinical application.

Acknowledgements

No acknowledgement found.

References

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Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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